A Smart-Alarm Detection and Deterrent System for Long-Tailed Macaque Intrusion in Human Residential Zones.

Rating scales, including visual analogue scales (VAS), are brief, informative methods to measure and value health outcomes on a continuous scale [, ]. A VAS can provide interval‑level data to complement an instrument’s descriptive system, either by measuring a different construct or by anchoring the same construct on a continuous metric. Existing EQ-5D instruments include an accompanying VAS, the EQ VAS, which asks respondents to rate their current health status on a vertical line ranging from 0 to 100, anchored with the “worst imaginable” and “best imaginable” health []. However, a VAS was not included in the development framework of the EQ-HWB-9, a generic, preference-based measure designed to evaluate health, social care, and carer-related quality of life [, ]. While initially conceived as a means to prime respondents for valuation tasks rather than measure individual health status, the EQ VAS has become an important complement to the EQ-5D descriptive system and the health state utility values that are determined based on population-level scoring through value sets [, ]. The EQ VAS does not have the same limitations as the EQ-5D index score (reflecting population-level preferences) and exists as a truer self-assessment that can inform patient-centered decision making [, ]. Although the EQ-5D is less commonly used in regulatory submissions to the European Medicines Agency (EMA) or US Food and Drug Administration (FDA), where it typically plays a supplementary role, EQ VAS ratings can be especially useful when index values are not easily interpretable or when patient-centered assessments are prioritized, including in health technology assessment (HTA) contexts. In one review of uses of the EQ-5D in HTA, the EQ VAS was used in nearly 70% of HTAs that included the EQ-5D, particularly in Germany where patient-centered outcomes are prioritized []. Research applications of the EQ VAS show that it broadens respondents’ considerations of their health status beyond the EQ-5D items, particularly incorporating broader conceptions of mental health [, ]. Thus, a VAS alongside the EQ-HWB-9 could be an important and valuable addition to the instrument, with potential roles as a valuation task, a summary of the descriptive system on a single, continuous metric, or a complement of the instrument’s nine items and utility estimates with a patient-centered global assessment. The use-cases of a VAS alongside the EQ-HWB-9 by researchers and policymakers are dependent on design decisions, including related to the specified construct and recall period, and their associated measurement properties. There are ongoing uncertainties about what the EQ VAS actually measures, how design features such as labels and endpoints influence interpretation, and how respondents conceptualize their responses [, , ]. Additionally, the construct validity of the EQ VAS has been found to vary based on mode of administration (self-complete or interview), population type (general public or patients), and geographic region (generally better construct validity in Europe and North America versus Asia) []. While incorporating the existing EQ VAS within the EQ-HWB-9 would confer an advantage of comparability with EQ-5D instruments, other options could be considered to either address shortcomings of the EQ VAS and/or tailor the VAS to align with the broader measurement focus of the EQ-HWB-9.